HSG test and Insurance coverage

knoll · August 2011

Ladies,

I have done my first IUI and in the rounds for the 2nd. I had an Endomentrial biopsy which came back fine. Doc (RE) said that she wanted to do 2 more IUIS then an HSG test.

I asked if we can do this before I spend $300 more dollars on IUIS... She said we can but alot of insurances wont cover it until youve proven you are infertile ( by not getting pregnant with IUIS and a positive PCT) or wont cover it at all. I told them to call my insurance company and check because if they cover I want to do this now. ( when I have called insurance they said they cover diagnosis and everything but not IUI or IVF, so im assuming this will be covered) So waiting till tomorrow to hear what insurance says.

Ladies who have done this what did your insurance cover and what was your out of pocket??

zookbride · August 2011

You may have to talk to your insurance company about that. I don't see a point in doing IUIs before finding out if your tubes are even open or not. My HSG was completely covered and that was before I started any medications with my RE.

Oh and my ins doesn't cover anything IF related, I guess diagnostic procedures were...but my RE's office took care of all the ins. stuff for me.

knoll · August 2011

Sweet thanks..

I think everyone does fertility and the procedures and what you do in total different orders.

I had no problem with doing the 1 IUI first. What did it hurt? I have been very lucky with my ins. they have covered all my apts ( i paid my copay) all my scripts are $5 thanks to my hubbys great insurance. Even my HCG shot I paid $5 for and my doc said most ins companies dont cover and its like $140. My IUI was $300, little bit of a sting but oh well, all of this is a sting!

I think my ins will cover the HSG and I will do that before I do the other IUIS.. I definitly feel at this point that it should be done now.

So we will see!

JCBR3 · August 2011

Hey!! I am suprised your doctor didnt make you do a HSG before IUI. I will be going for my HSG in a month.My husband and I got all the testing and did clomid for two months...nothing happenend. This is the next step. Personally, I dont want to do IUI. I want to go straight to IVF but I dont think any ins will allow us to do it this way. My ins covers 3 tries for IVF. Everyone I have talked to only got pregnant by IVF not IUI. Let me know what your ins tell you.

zookbride · August 2011

JCBR3:
Hey!! I am suprised your doctor didnt make you do a HSG before IUI. I will be going for my HSG in a month.My husband and I got all the testing and did clomid for two months...nothing happenend. This is the next step. Personally, I dont want to do IUI. I want to go straight to IVF but I dont think any ins will allow us to do it this way. My ins covers 3 tries for IVF. Everyone I have talked to only got pregnant by IVF not IUI. Let me know what your ins tell you.

There are plenty of ladies that have gotten pregnant with IUIs. Also, IUIs are a lot less invasive than IVF. If there is a good reason to jump straight to IVF, like severe MFI, then ok, but I don't see why you wouldn't want to do some IUIs first.

I guess, I understand that if ins. covers it, then that's a different story. But if you have to pay OOP, IUIs are definitely the way to go (unless like I said before, there is a reason to believe an IUI wouldn't work).

Temp423319000008365 · August 2011

That's interesting that you did IUI before an HSG, but I know all Dr.s do things differently! For me, my insurance covered 80% of my HSG after I met my deductible. My HSG was $3,000, which is on the high side I think because I had mine done in a hospital. I wound up paying $1500 out of pocket, which included my $1100 deductible. Hope this helps!

zookbride · August 2011

knoll:
Sweet thanks..

I think everyone does fertility and the procedures and what you do in total different orders.

I had no problem with doing the 1 IUI first. What did it hurt? I have been very lucky with my ins. they have covered all my apts ( i paid my copay) all my scripts are $5 thanks to my hubbys great insurance. Even my HCG shot I paid $5 for and my doc said most ins companies dont cover and its like $140. My IUI was $300, little bit of a sting but oh well, all of this is a sting!

I think my ins will cover the HSG and I will do that before I do the other IUIS.. I definitly feel at this point that it should be done now.

So we will see!

I didn't say it hurt anything, I would just assume that your RE would want to make sure your tubes are clear before going through an expensive procedure.

I can't tell by your reply, but I wasn't being snarky when I replied. It just seems like that's the way you took it.

brookelynpaisley · August 2011

knoll:
Ladies,
I have done my first IUI and in the rounds for the 2nd. I had an Endomentrial biopsy which came back fine. Doc (RE) said that she wanted to do 2 more IUIS then an HSG test.
I asked if we can do this before I spend $300 more dollars on IUIS... She said we can but alot of insurances wont cover it until youve proven you are infertile ( by not getting pregnant with IUIS and a positive PCT) or wont cover it at all. I told them to call my insurance company and check because if they cover I want to do this now. ( when I have called insurance they said they cover diagnosis and everything but not IUI or IVF, so im assuming this will be covered) So waiting till tomorrow to hear what insurance says.
Ladies who have done this what did your insurance cover and what was your out of pocket??

I'm personally shocked you've done one IUI with plans for another without making sure your tubes aren't blocked. I'd be seriously questioning the methods of this RE.

My insurance covered my HSG, but was told that it would be $700 OOP at that partcular imaging center. After insurance discount, I paid $282 because my deductible had not yet been met.

JCBR3 · August 2011

I guess I feel like I have been through so much already with TTC, I just want it to be over with. My level of patients are low at this time. I'm sure you are familiar with this feeling? Hard to go through.....

knoll · August 2011

@ zookbride Didnt take it snarky.. Just putting more info out their i guess...

No worries!

brookelynpaisley · August 2011

knoll:
Didnt take it snarky.. Just putting more info out their i guess...

No worries!

Use the quote button instead of reply. It helps us follow conversations more easily without having to scroll up to see what you're referencing

brookelynpaisley · August 2011

knoll:
Sweet thanks..

I think everyone does fertility and the procedures and what you do in total different orders.

I had no problem with doing the 1 IUI first. What did it hurt? I have been very lucky with my ins. they have covered all my apts ( i paid my copay) all my scripts are $5 thanks to my hubbys great insurance. Even my HCG shot I paid $5 for and my doc said most ins companies dont cover and its like $140. My IUI was $300, little bit of a sting but oh well, all of this is a sting!

I think my ins will cover the HSG and I will do that before I do the other IUIS.. I definitly feel at this point that it should be done now.

So we will see!

It didn't HURT anything but you mentioned that the IUI was a "sting" at $300. Now what if you go through a second and third before an HSG and it turns out you have a blocked tube (s). That's $900 down the drain. That's why an HSG is generally done prior to any treatment. There are three components to conception: the sperm, the egg, and the path. It makes the most sense to know all possible issues with each of those three before doing treatments blindly.

knoll · August 2011

brookelynpaisley:
knoll:

I'm personally shocked you've done one IUI with plans for another without making sure your tubes aren't blocked. I'd be seriously questioning the methods of this RE.
My insurance covered my HSG, but was told that it would be $700 OOP at that partcular imaging center. After insurance discount, I paid $282 because my deductible had not yet been met.

Yea I am new to all this so didnt know what should be done and in which order. I go with my doctors recommendations on most occasions but we are at the point where we have started asking""more" questions. Like why this wasnt done first. If my ins covers it I will be disappointed we didnt do it first but if they dont then I think the $300 is cheaper than the other.. But if were just going to end up at the HSG anyways I guess it doesnt matter..

Ahh this is the first time im getting stressed over all of this. I dont know how women can handle this for so long.

Sorry started to vent and didnt mean to.

I so appreciate everyones advice and recommendations.. I am growing my list of qs for RE tomorrow!!

knoll · August 2011

brookelynpaisley:
knoll:
Didnt take it snarky.. Just putting more info out their i guess...

No worries!
Use the quote button instead of reply. It helps us follow conversations more easily without having to scroll up to see what you're referencing

Thanks i was hitting all buttons trying to find that and was writing my first "quote" reply when you typed that!!

RovinChick · August 2011

I would push for the HSG before any more IUI's. My insurance also wanted to see a diagnosis of infertile, but that was made by telling the doctor we tried for a year with no luck - I have never heard of a diagnosis being made by 3 failed IUI's. It really would be a waste of $600 if your tubes were blocked. I hope your insurance will cover the HSG now and your doctor will agree to do it. Good luck!

knoll · August 2011

brookelynpaisley:
knoll:
Sweet thanks..

I think everyone does fertility and the procedures and what you do in total different orders.

I had no problem with doing the 1 IUI first. What did it hurt? I have been very lucky with my ins. they have covered all my apts ( i paid my copay) all my scripts are $5 thanks to my hubbys great insurance. Even my HCG shot I paid $5 for and my doc said most ins companies dont cover and its like $140. My IUI was $300, little bit of a sting but oh well, all of this is a sting!

I think my ins will cover the HSG and I will do that before I do the other IUIS.. I definitly feel at this point that it should be done now.

So we will see!
It didn't HURT anything but you mentioned that the IUI was a "sting" at $300. Now what if you go through a second and third before an HSG and it turns out you have a blocked tube (s). That's $900 down the drain. That's why an HSG is generally done prior to any treatment. There are three components to conception: the sperm, the egg, and the path. It makes the most sense to know all possible issues with each of those three before doing treatments blindly.

No I totally agree.Yall are opening my eyes.. before this I thought oh $300 no big deal but I get it if I end up at HSG anyways!! Dr is checking with Ins and calling me tomorrow so we will see what they say!

DrRx · August 2011

I actually started with my OB/GYN regarding being unable to get pregnant after about 1 year, and one of the first things she did was order an HSG for me. My insurance paid for the HSG as an outpatient procedure, which was like $100 or $125.

Shayliz · August 2011

I agree with the previous posters about doing an HSG before more IUIs. Mine was covered by my insurance and I paid a $35 copay for it and they billed insurance $432.

Blueyed228 · August 2011

My insurance covers everything. My HSG cost a $15 co-pay. However, a lot of insurances will cover infertility diagnostic testing and usually an HSG is used for just that. A diagnosis since it will tell you if your tubes are blocked or if you have a cyst.

sarahtoledo · August 2011

Without insurance, my HSG would've cost $2400. I was shocked to see that. With insurance, thank goodness, I paid $16.

My RE felt there was a slim chance I had tubal issues, and I already had a Dx, so I actually asked for the HSG just in case. Turns out there were no tubal issues.

Now, my doctor isn't perfect, but I kind of like that he doesn't just order up every expensive, invasive test in the world for everyone who steps into his office. I think he looks at the history and deals with each person as an individual, and uses his best judgement.

Yes, it's possible I could've done several medicated cycles and then found out that my tubes were blocked. But the odds were that my tubes were not the problem.

This is all just JMO.

twotexans · August 2011

When we had our 11th failed cycle I went into my OB. The wanted us to try for 6 months, but I waited closer to 9 months, My OB immediately ordered an HSG, a PCOS blood work panel, a SA for DH and referred me to an RE. We have no IF coverage beyond diagnostics. Our insurance covered the HSG, and we paid about $200 with co-insurance and deductible amounts. I called my insurance company before I scheduled it, to make sure it was covered.

Good Luck!

knoll · August 2011

Update:

I got a call from my RE and my HSG is scheduled for Wednesday and per my Insurance I owe nothing!!

I am excited and hope that all is well with my test!

mandalinn25 · August 2011

I am glad your was covered. Mine was not and it was $660, but I was glad to know that there was no blockages. Good luck.

DoubleBubble08 · August 2011

Ours was covered because it fell under diagnostic testing. I have coverage up until diagnostic testing is done. If not DX then no coverage.

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